A scoping review of risk determinants for workplace violence in emergency departments

Workplace violence refers to physical violence, verbal abuse, threats, or other aggressive behaviors directed toward healthcare workers in the workplace. It is a critical occupational and public health hazard, disproportionately affecting emergency departments (EDs) worldwide. This scoping review aimed to synthesize evidence on the prevalence of ED violence and to map its risk determinants through the lens of 'Who, When, and Why'. We conducted a scoping review following PRISMA guidelines, including qualitative, quantitative, and mixed-method studies on risk determinants for ED violence. PubMed, Scopus, Embase, and Web of Science were searched from inception to June 2025. English-language studies reporting prevalence or risk factors of ED violence were included. Titles and abstracts were screened using ASReview. Twenty-one studies were included, reporting workplace violence prevalence ranging from 72.5% to 91.5%. Thirty-four influencing factors were identified across four dimensions: individual characteristics (perpetrator traits: male gender, middle age, psychiatric illness, substance use; healthcare worker traits: provider gender), temporal triggers (night shifts, weekends, long waiting times), spatial vulnerabilities (triage and treatment areas, overcrowded or poorly monitored spaces), and situational/psychological drivers (pain, fear, unmet expectations, miscommunication). Workplace violence in EDs is a multifactorial phenomenon shaped by individual vulnerabilities, environmental pressures, and systemic factors. This review highlights the persistent normalization of violence against frontline staff and underscores the need for immediate protective measures and systemic reforms.